SAMUEL IGHODARO
NPI 1184597072
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Q: What is Samuel Ighodaro's NPI number?

The NPI number for Samuel Ighodaro is 1184597072. It was assigned to this individual provider in the NPPES registry on September 26, 2025.

Q: What is Samuel Ighodaro's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Ighodaro was last updated on May 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 26, 2025PECOS Enrolled

1439 JESSE JEWELL PKWY NE STE 102, GAINESVILLE, GA 30501(770) 219-8730 Get Directions Write a Review

NPPES record last updated: May 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 25, 2026, Apr 10, 2026 (2 updates tracked since 2026).

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About Samuel Ighodaro NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL IGHODARO (NPI 1184597072) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184597072

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL IGHODARO

Location Address1439 JESSE JEWELL PKWY NE STE 102Gainesville, GA 30501-3806

Mailing Address1439 Jesse Jewell Pkwy Ne Ste 102Gainesville, GA 30501-3806 · (770) 219-9445

Phone(770) 219-8730

Sole ProprietorNo

Enumeration DateSeptember 26, 2025

Last NPPES UpdateMay 25, 20262 updates tracked since enumeration

NPPES CertifiedMay 25, 2026

✔ NPI 1184597072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1439 JESSE JEWELL PKWY NE STE 102, Gainesville, GA 30501

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Ighodaro is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INDRANIE RAMSAROOP

Student in an Organized Health Care Education/Training Program